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Follow-up
•After starting antihypertensive drug therapy, the patient should see his or her doctor at least once a month (or as prescribed) until the blood pressure goal is reached.

•After the blood pressure goal is reached, the patient should see the doctor every three to six months (or as prescribed), depending on whether he or she has any associated diseases or complications such as heart failure.

Facts About Hypertension
The human heart pumps blood through the blood vessels in a wave-like pattern. The highest point of the wave corresponds to the heart’s contraction. The blood pressure at the peak of the heart’s contraction is known as the systolic blood pressure. When the heart relaxes, the blood pressure falls, and a lower level of blood pressure occurs, known as the diastolic blood pressure. This systolic and diastolic blood pressure is measured at routine doctor’s visits and hospitalizations. If you are told that your blood pressure is 120 over 80, then your systolic pressure is 120 and your diastolic pressure is 80. This is an ideal blood pressure. Hypertension is defined as an elevation in the blood pressure over these ideal levels. If either the systolic or the diastolic blood pressure is persistently greater than this, hypertension is said to be present.

What makes blood pressure go up? What happens when it does?
Blood pressure changes in each of us throughout our lives, and on a minute-to-minute basis. It tends to get higher as we age, and is usually lowest when we sleep.

As we go through a normal day, it fluctuates and becomes elevated in response to stress, pain, hormonal levels, meals and exercise. These are normal responses to our environment. In the disease of hypertension, the blood pressure becomes higher than necessary to maintain normal body functions.

This elevation begins to damage the circulatory system, increasing the “wear and tear” everywhere there are blood vessels. The heart, which must work harder to push the blood through a higher-pressure environment, begins to increase in size. The walls of the heart thicken and the heart muscle doesn’t relax normally. The walls of the blood vessels also thicken and become stiffer. They can develop damage to the inner lining of the blood vessel, with resulting cholesterol deposits at the places of damage. This process, known as atherosclerosis, can lead to strokes, heart attacks and blood vessel enlargements known as aneurysms.

What is White Coat Hypertension?
Most of us become a little anxious when we visit our doctors, and “white coat hypertension” is the term for the higher than usual blood pressure often recorded during a routine check. What we now know, however, is that if a doctor’s visit begets high blood pressure, so does being late for an appointment, getting stuck in traffic, and getting a phone call from your car mechanic. It now appears that what used to be dismissed as a temporary increase in the blood pressure probably represents a true tendency to hypertension, which should be taken seriously and treated.

Is Hypertension a Big Problem?
Many Nigerians have high blood pressure. Almost half are not on treatment, and less than one third are adequately treated. Costs of treatment of strokes, heart attacks and congestive heart failure cost billions of naira yearly.

How To Prevent Hypertension?
See a doctor. A healthy diet and adequate exercise will help. If you smoke, quit. If your doctor prescribes medications, take them as directed. If you take herbal or nutritional supplements, be aware that some can cause hypertension while others may interfere with your medication.
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